Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,563.96 / $4,962.67 / $15,341.00	Facility		$1,563.96	$4,962.67	$15,341.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,138.55 / $1,564.75 / $1,917.23	Professional		$1,138.55	$1,564.75	$1,917.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $851.29 / $1,153.28 / $2,072.96	Facility		$851.29	$1,153.28	$2,072.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,063.69 / $1,519.56 / $1,679.69	Facility		$1,063.69	$1,519.56	$1,679.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $888.48 / $1,378.76 / $3,005.10	Facility		$888.48	$1,378.76	$3,005.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,573.85 / $5,897.44 / $7,048.47	Facility		$4,573.85	$5,897.44	$7,048.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $5,130.00 / $7,385.00	Facility		$1,689.00	$5,130.00	$7,385.00